HealthCheck Training

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Post-Test

Overview

• EPSDT Benefits
• HealthCheck EPSDT
  • Goals
  • Participants/Providers
  • Support Services
  • Coordination

Health Supervision

• Introduction
  • Screens
  • Diagnosis/Treatment/Referral
• Health History
  • Initial History
  • Interval
  • Specific Visits
• Physical Examination
  • Unclothed Exam
  • Body Measurements
  • Specific Visits
• Screening Services
  • Nutrition
  • Vision
  • Speech/Language
  • Hearing
  • Development/Behavior
• Laboratory Tests
  • Metabolic
  • Sickle Cell
  • Lead
  • Anemia
  • Urinalysis
  • Cholesterol
  • Tuberculosis
  • STDs
• Immunizations
  • Schedule
  • Vaccines for Children Program
  • Documentation
  • Precautions/Exceptions/Contraindications
• Health Education
  • Tips for Working with Families
  • Tips for Working with Teens
  • Specific Visits

Special Health Issues

• Introduction
• Dental Health
  • History/Evaluation
  • Guidance/Referrals
  • Dental Services
  • Provider Resources
• Overweight and Obesity
  • Screening
  • Assessment
  • Treatment/Referrals
• HIV Guidelines
• Child Abuse & Neglect
• Language Barriers
  • Resources and HIPAA
  • Interpreter Tips
• Early Intervention

Documentation

• Guidelines
• Reporting
• EMRs and Required Data
• Billing Procedures
• Billing Codes

Go To Resources »

Health Supervision

Laboratory Tests: Iron-Deficiency Anemia Screening

Iron deficiency is the most common cause of anemia in U.S. children and adolescents. The risk of anemia is greatest in infancy and adolescence because of increased iron requirements during these periods of rapid growth.

Risk Assessment and Health Education

Assess child's or adolescent's risk of iron-deficiency anemia, and provide targeted health education/guidance, treatment, and referrals as needed. Assess risk through:

• Review of health history and risk factors (e.g., low birthweight or preterm birth, non-iron-fortified formula, cow's milk before age 12 months, inadequate nutrition, heavy menstrual periods, intensive physical training).
• Review of nutrition assessment (quality and quantity of daily food intake).

Periodicity and Guidelines for Anemia Screening

HealthCheck requires iron-deficiency anemia screening at key developmental ages (more frequently if child or teen is at high risk):

Infancy and Early Childhood:

• Screen all infants at 9-12 months.
• If infant at high risk: Screen earlier than 9 months.
• If child at high risk: Screen again at 15, 18, and 24 months.

Childhood:

• If child at high risk: Screen at each preventive health visit from 3-10 years.

Adolescence:

• Screen once between 11 and 20 years.
• Screen menstruating females annually.

Screening Guidelines

Screen with a blood test (hematocrit or hemoglobin), using one of these methods:

• Venipuncture with analysis by automated cell counter
• Capillary puncture with microhematocrit analysis by centrifuge

If the microhematocrit method is used, follow the principles of collection listed below:

• In infants, collect the sample from medial or lateral aspect of the plantar surface of the heel. In older children, collect the sample from the medial or lateral aspects of the pulp of the finger. Make the puncture perpendicular to the skin and across the dermal ridges.
• To increase blood flow, apply a warm (100° to 108° F) moist towel to the site.
• Avoid massaging the collection site, since this may dilute the sample with tissue fluids.
• Before puncturing the skin, clean the site with an antiseptic and let it dry.
• For infants 6 months or younger: Use sterile, disposable lancets with tips less than 2.5mm long. For older children, lancets with longer tips (up to 5mm) may be used.
• Wipe away the first drop of blood (which contains tissue fluid) with dry sterile gauze.

Resources

Centers for Disease Control and Prevention. 1998. Recommendations to prevent and control iron deficiency in the United States. MMWR 47 (No. RR-3)

Story M, Holt, K, Sofka D, eds. 2002. Bright Futures in Practice: Nutrition (2nd ed.) [chapter on Iron-Deficiency Anemia: pp. 196-202]. Arlington, VA: National Center for Education in Maternal and Child Health. Also available online at www.brightfutures.org/nutrition/PDF/index.html.